As you approach retirement or explore your Medicare options, you may notice more conversation around dental coverage. Oral health plays a major role in overall wellness, especially as we age, but understanding how dental benefits work for seniors and Medicare Advantage members can be confusing.
Let’s break down what’s typically covered, and how to make the most of your benefits.
Even if you’ve had a lifetime of healthy teeth, your oral health needs change over time. Aging can increase your risk for gum disease, dry mouth (often linked to medications), and tooth loss—all of which can affect nutrition, confidence, and quality of life.
Regular preventive care helps catch problems early and allows you to maintain a healthy smile. That’s why understanding your coverage options, and using your benefits before they reset in the new year, is so important.
It’s important to know that Original Medicare (Parts A and B) does not include coverage for most routine dental care. Services like cleanings, fillings, extractions, dentures, and implants typically aren’t covered, which can come as a surprise to many retirees.
However, some Medicare Advantage (Part C) plans, private plans that combine your Medicare benefits, may include additional coverage for dental, vision, or hearing care. The details vary from plan to plan.
If you’re enrolled in a Medicare Advantage plan, take time this fall to:
Review your plan’s Summary of Benefits for details on dental coverage.
Check whether your current dentist is in-network.
Note any changes for the upcoming plan year, such as new annual maximums or covered services.
If your current coverage doesn’t include dental, or only covers a limited number of services, you may choose to add an individual dental plan.
An individual plan can help fill coverage gaps by providing benefits for preventive visits, basic services like fillings, and major services such as crowns or dentures. For many retirees, this added protection helps manage predictable dental expenses and avoid unexpected costs.
When comparing options, consider:
Coverage for preventive care: Routine exams and cleanings are often covered in full.
Annual maximums and deductibles: These determine how much your plan pays each year.
Network size: Seeing an in-network dentist can lower your out-of-pocket costs.
Even if you’re retired, having dental coverage remains one of the most effective ways to protect both your oral and overall health.
As the end of the year approaches, it’s a good time to check in on your dental benefits and make sure you’re getting the most from them.
Here’s how:
Use your preventive visits. Most plans cover two cleanings per year, schedule yours before December 31 if you haven’t already.
Check your annual maximum. If you’ve met your deductible but haven’t reached your plan’s maximum, you may be able to complete additional treatment before benefits reset.
Ask about treatment timing. If your dentist recommends multiple procedures, they can help plan what to complete now and what to schedule for the next plan year.
Confirm 2026 coverage details. Whether you’re enrolled in a Medicare Advantage plan or an individual dental plan, review any updates for the upcoming year. Networks, covered services, and limits may change.
Book early. Many dental offices fill up fast at the end of the year. Scheduling early ensures you get the care you need while maximizing your benefits.
A healthy smile is part of staying healthy overall, and it’s never too late to take care of your teeth and gums. As you plan for the year ahead, make sure your dental coverage meets your needs and budget.